Mayo Clinic’s Office of Access Management functions as the front door for one of the most complex health systems in the country, spanning more than 42 specialties, 800+ remote agents nationwide and multiple time zones. In 2025, the team handled over four million patient contacts. Let’s do the math on this: that’s about 16,000 calls a day.

When agents shifted to remote work during the pandemic, managers had to shift their mindset on how direct their teams. At our conference this summer, Cassie Crary, operations manager at the Office of Access Management at Mayo Clinic, spoke to our audience about the team’s approach. 

Agents were handing calls from home offices, spare bedrooms and kitchen countertops. They navigate scheduling systems with rules that change constantly. They help patients who are scared, confused or frustrated. Because they were working remotely, they no longer had the chance to lean over to a colleague or catch their manager’s eye across the floor.

“When our teams transitioned to remote work, we were honest with ourselves about what our risks were,” Crary says. “In an onsite contact center, a manager develops an intuition. You can read your team and you feel their presence. You notice when something seems off. All of that disappears when your team goes remote.” 

Crary wanted to make sure she built a new leadership structure that could reach agents consistently, reliably and meaningfully. She and her management team created a virtual rounding program. As you probably know, “rounding” isn’t a new idea and has roots in healthcare quality improvement. 

Mayo Clinic’s virtual rounding focused on structured, scheduled, one-on-one conversations between leaders and staff, designed to replace the organic connection that disappears in a remote environment. The core of the model is four questions, asked consistently at every rounding session: How are you doing, really? What’s working well right now? What’s getting in your way? And is there anything you need from me?

“These questions create a reliable, predictable space for staff to know that their voice will be heard, that their concerns will be documented and that their leader will follow through,” Crary says. 

When the team gathered feedback from staff after implementing virtual rounding, the responses showed what had been missing without it. Crary shared a few examples during her presentation: 

“I finally feel like my manager knows what my day actually looks like.”

“Knowing I have a standing check-in means I don’t have to bottle things up anymore — I just wait and bring it to them.”

“It’s the one time in the week I feel like I’m not just a number on the dashboard.”

Crary says these responses tell her that staff was bottling things up.

“They were feeling invisible,” Crary says. “They were experiencing their work as transactional rather than meaningful. Rounding didn’t just improve our metrics, but it changed the emotional experience of being on the team.” 

Since launching virtual rounding, scheduling accuracy improved by 15% over six months. Not because staff suddenly became more careful, but because rounding gave them a safe, one-on-one space to ask questions about new protocols before those questions became errors. Staff who felt psychologically safe were also more likely to report near misses early, allowing leaders to address root causes before they compounded.

Issue resolution sped up by 30%. Before rounding, average issue resolution was more than 5 days. After rounding, it’s between two and three days. Problems like tech glitches, workflow bottlenecks and/or interpersonal tensions were caught earlier because staff had a scheduled, protected channel to raise them. Staff satisfaction scores moved in the areas that matter most: feeling informed, feeling heard and trusting that concerns would be addressed.

“When your staff satisfaction scores go up, your patient experience scores follow,” Crary says. “Rounding creates a direct line between how leaders treat their staff and how staff treat patients. The question is not whether you have time to round. The question is whether you have time not to round.” 

Crary says that getting started is easy. You can have a rounding conversation guide with the same four questions, shared with staff in advance so they can prepare. You can use a simple tracker to document themes, action items and deadlines. It’s also important not to cancel a rounding session because it sends a message to agents that it doesn’t matter. Remember to do a short post-survey at 30 days to see how everything is going.

“You can start before you’re ready,” Crary says. “Don’t overthink it. You don’t need a perfect system. You need to be consistent. The number one failure for a rounding program isn’t bad execution, but inconsistency. If you round for three weeks and then stop, you’ve done more harm than good. Leadership doesn’t disappear when teams go remote. It just has to become more intentional.”